Ellen Rose Wilson, PT, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

297108 Issued in CA

Practice address

19960 Santa Maria Ave
Castro Valley, CA 94546-4220

Phone

(510) 999-8936

NPI assigned

Jan 7, 2022

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1641513600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641513600000",
    "number": "1174284517",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2019 SHORELINE DR APT 315",
            "city": "ALAMEDA",
            "state": "CA",
            "postal_code": "945016110",
            "telephone_number": "925-989-7914"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19960 SANTA MARIA AVE",
            "city": "CASTRO VALLEY",
            "state": "CA",
            "postal_code": "945464220",
            "telephone_number": "510-999-8936"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4115 Mohr Ave",
            "address_purpose": "LOCATION",
            "city": "Pleasanton",
            "state": "CA",
            "postal_code": "945664740",
            "country_code": "US",
            "telephone_number": "925-461-8409",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILSON",
        "first_name": "ELLEN",
        "middle_name": "ROSE",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-01-07",
        "last_updated": "2022-01-07",
        "certification_date": "2022-01-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "297108",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Janeyah Lenai Williams
• Julian JJ Warren Williams Sr.
• Teaira Williams
• Ann Wilson, PSY.D.
• Byron Eric Wilson, M.D.
• Isabelle Laure Wilson
• James Michael Wilson, DDS
• Zane Wilson, NP
• Wing Chin, M.D.
• Daniel Wittman, D.C.

• Physical Therapist in Castro Valley, CA
• Providers in Castro Valley, CA by specialty
• Physical Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.